99080042 (2) APPLICANTTO FI L IN INFORMATION WITHIN RED LINES-USE BALL POINT PEN ONLY
CITY OF CUPER INO BUILDING-ELECTRICAL ERMI NO.
BUILDING DIVISION APPLICATIONIPERMIT PLUMBING.MECHANICAL
(". . !t BUILDING PROJECT IDEWIFICATION=L i,¢s. j,
BUILDING ADDRESS'. SANITARY NO. /MITTAL DATE
0 100 S be- A10-2;+ u evQa7t car �MRd�/lO &,01 IS J
OWNE ryyh_ - O� ��HONE: 5 CONUHAi ITV LIC' L✓IW�Xa �O O�i7
I�_'./,T/'A N NAME:1y 1 (^j T� NIC CONTROLR
GHITECTIENGINFFR'. LIC NO: ADDRESS
ZSSC, ILS 1A.T cJ1� �I'1 NW](' /q ❑
ONTACT: PHONE: ;'i,l i', BUI iDWG PERMIT,'INFO
r
Z4 ❑ Consultant Feos Paid by Applicant(Initial) BLDG ELECT PLUMB MECH
❑ ❑ ❑
LICENSED CONTRACTORS DECLARATION QTY , t{ t CLECTRICIPPRMIT j` ; r - . 'k}•' FEE
1 hereby affimr that l a licensed d p of (p,mmen g ., , .�{ v. .• ., .=t .t,t5.' JOB DESCRIPTION
Qa'$ with Sactian90yd0)OfD vt on3ofor Bre, 'adPrf..ns Code and my license is
R00 IIle am PERMIT ISSUANCE RESIDENTIAL
In full Tome and a •qp
C V F v G 3/ R S Cl ❑SFDWL El KITCHEN REMODEL
V License Co tt
Ra' nod
Uaa Cnmractor APPLIANCES-RESIDENTIAL ❑ADDITION L1 PLUMBING RE-PIPE
AR HIT
BUT DECLARATION PANELS ❑MULTI-UNIT ❑STRUCTURAL
Z O 7 1 vodin mid any plans shall be used as public records MODIFICATION
OZ-p 200A S El INTERIOR ❑CHIMNEY REPAIR
F L2.t:u1 Licensee Posab000nal 201- - S IMPROVEMENT
�ae2 OWNER-BWLDFRDECLARATION El SWIMMING POOLS
Z W . I hereby affirm that I am exempt from the CorImcmr's License Law fnr th OVE AM ❑BATH REMODEUREPAIR ❑DEMOLITION
d V fallowing reason.(Section 9031,5,Business and Professions Code;Any city ,,pmn SIG ' ECT I AL ❑ THER
which r.quires a permit to construct,alter,impmva,demolish,m repair any but "'
poor toits issuance,also requires the applicant for such permit to rile a signed amtem
TME
ITIMISC.
�a d� the`M1oisliwnsdpurwanttotheprovisionsoftheContramor9LicenseLuw(Clipter9
ty� p (eommencingwith Section 9000)afDivismn 3 ofine Business and Rofessions Code)or TEMP. RPOLEI T
d y e a that he is exempt therefrom and the basis for the alleged exemption.Any violation of NEW IT
❑DEMOLITION
V"co Section 9031,5 by any applicant for a permit subjects the applicant In a civi l pemhy of POWER DEVICES OaPErANT
FOOD SERVICE
dnot one than five hundred dollars($5011).
❑ 1,naownerofthe pmpetty,many employees with wages as their sole compensation, SWIMMING POOL ELECTRIC I IMPROVEMENT
E2 will do the work and thexwcmre is not intended oroHered Elide(Sec.9044,Bruins IDOTHER
Wilt= and Professions Code:The Comctorm's License Law does nut apply an owner of OUTLETS-SWITCHES-FIXTURES p
4i property mproperty who builds or Improves thereon,and who does such work himself or through I
his own employees,provided that such improvements are not intended or offered for NEW RESIDENTIAL EI.FCTR SQ ET.
sale If.however,the buildhigm"FoploconvOt is sold within one yearidtompledum.theD _ 0 A A I SQ.Pr.
wnerbulderwll have the burden fp ',that he didon,b Itl or imp rip
pose f ).
❑cens1 e Law stoeer oftheep lypt ay am exclusively
contracting with licensed contractors
tamdTOTAL
Q�'y' PLUMBING PERMTPis I TOTAL
mrs,me,thedurofcct(S c 9044 Brininess d Plefiellical Critic)To,Ctrot ,Li
) �aP•EEt . AUG, O
1999
who contracts for such projects with ocontortionist 1'censud pursuant
tothe Contractor's
Licenre Lot.
PERMIT ISSUANCE
❑lam exempt unser Sec. ,R&PCfar this rensov _
caner DateALTER-DRAIN @ VENT-WATER(EA)
WORKER'S COMPENSATION DECLARATION 4 BACKFLOW PROTECT DEVICE Z DQ
1 hereby affirm under penalty of perjury one of the following declarations:
I have and will mainmina Certificateof Consent roself-Insure fnr Worker's Camper- DRAINS-FLOOR,ROOF,AREA,COND. STOR 'fYPECONSTRUCTiON
tion,as provided for by Section 3900 of the Labor Code,for the performance of'ha
work for which this permit is issued FIXTURES-PER']RAP
❑1 have and will maintain Workers Compensation Insurance,as required by Section
3900 nfthe La ho Cade performance of the work for which this permit is,rsaed. GAS-EA.SYSTEOUI INC.4 OUTLETS
vvv!!! My Worker' Inwmnce carrierand Policy number are: OCG GROUP O `Q pPpL
Corner s o - Policy No GAS-EA.SYSTEM-OVER 4(EA) J I C-1
CERTIFICATE OF EXEMPTION FROM WORKERS' 0
COMPENSATION INSURANCE GREASP/INDUSTRL WASTE INTERCEPTOR
ly(This section need not Be completed it the permit is for one hundred dollars(8100) #'K6 BUB,.DING't)IVISIONrFEN wm41aYA
tole".) GREASE TRAP
PLANCHECK FEE
Ioyany Ic'hat mo in performance any means, the work
which thl.perdid it Worker,'
edleho0 gEWER_SANITARY-STORM EA. TTI'.
not employ any person in any manner so as to became avhject to the Workeri Grmpen- ENERGY PEE
Q ,Z radar Law.of Coldomie.Date WATER HEATER WNENTIELECTR
7 App '
licant GRADING FEE
F7 NOTICE TO APPLICANT.If after making this Cenificate of Exemption,you should WATER SYSTEMC REATING
�^ become rvbject to the Worker's Compensation provisions of the Labor Code,you mu.l SOILS FEE
W [ forthwith comply with such provisions or this pchnno,holl be deemed revoked. WATER SERVICE
Q
CONSTRUCTION LENDING AGENCY NEW RESIDENTIAL PCMB. SQ.n'. PAID
U k for
reby which rm that mitisssued(Suc.i0n len ding agency(.,,he performance of _ Data ReeeiptM
W
the work far which this permit is issued(Sec 3097,Civ,CJ
>i Lenders Name TOTAL:
U
Lender's AAJress - TOTAL:
(~ Icertify that l have 'd thisapplication and stat that thebinformationis ..ii BUILDING FEE
'-ICA7 coned.I agree to comply mall city and countyordinancesad.tatelrelatingm QTY . t MECHANICAL PERM)T; FEB'Sr
V ❑ bolding construction and herebyauthorize r pescnmtivea of this city to enter machine i� s ° SEISMIC FEE
above-mentioned property forinspection purposes.
(We)agree m save,indemnify and keep harmless the City of Cupertino against PERMIT ISSUANCE ELECTRIC FEE
Iiab"''a.jue s,pats and expense.which h in any way ac a agelnst said City ACI'1?R OR ADD TO MECH.
incnmeyue Hof egraming of this permit. PLUMBING FEE
APPLIC T U ERSTANDS AND W COMPLY ALL NON-POINT AIR HANDLING UNIT(TO Ig000 CPM)
SOUR REG ATIONS� MECHANICAL.FEE
+� R AIR HANDLING UNIT(OVER 10,000 CFM) CONSTRUCTION TAX
lot I Si t of Apple uGrntraemr Dine [ EXHAUST HOOD(WIDUCI� HOUSING MITIGATION FEE
HAZARDOUS MATERIALS DISCLOSURE
Will the applicant or future heading occupant store or handle hazardous material HEATING UNIT(TO 1004000 BTU)
as defined by the Cupertino Municipal Code,Chapter 9.12,and the Health and Safety
Code,Section 25532(a)'! HEATING UNIT(OVER 100,00)BTU)
El Yes ❑No - VENTILATION FAN(SINGLE RESID) PAID
Will thea applicant or future building t use a Dale Receipt k
pp dby the
equipment Qm1ft devices which BOILER-CONE(3HP OR 100.000 BTU)
lbookchtlitch,
t hazardous air conmminanu ax JefneJ by the Bay Arca Air Quality Management
:Int". TOTAL: T
❑Yes ❑Nn BOILER-COMP(OVER 1(10,000 BTU) �(have sad the hvzanouuv materials quirementxo rGapterfl95 of the CWi- AIR CONDITIONER ISSUANCE DATE
ia Bea¢ v[ety Code,Swtion. -O5,25533 ay�fJ'534.Jrnderstand thatif theNEW RESIDENTIAL MECH. SQ,ET. ) Qs mulrenly hnvevt Lthat it is myle}(f`mMtfryWnotify Ne occupant e enk whit met pnono'eRGe l nCetti ne. ofOupancy.
rZ
rrmIImI eA age Dam TOTAL: ISSUED BY,
OFFICE
--------------------------------- - -----------
�T
PLOT PLANS
CBECKED BY
DATE s
u PLANA ::G ; PT.
1 DATE
BLDG. DFPT.
LFAUUG 199 D9
SITE PLAN
ranir,cr.ro SAN JOSE -
AWNING CCIMPANY, INC.
N4n,yf n__ __ ARMADILLO
WILLIES
-------------- ---- --------
••• r,rE_oat s17E imr._xa �.
3'-V
3'-0"
SAN JOSE
1 —� AWNING COMPANY, INC,
OMWN Sri
taloa'N YEN wre ARMADILLO WILLIES
6EEaEa ME �y
MPFOVEO — SCALE---
mm
NbtES
STEW Tubin�d/ASTMI 1"0
�-�Amt riNIS4 Pdwolercbatl 5ltvadlllo
....:EQUAL. FABRIC1,. ty06i SuhlbrpttQ.
CcL6i-1 Captain
EQUAL f�avy/Fbwest
GrOon/Yolltiw/fl -ntal
EQUAL
PLOT PlAft
C> ➢ BY
DATE et
rrvArA ' ; PT
DATE
TYPICAL END VIEW BT,DG. DEPT_
C0N UG10 SAN JOSE
AWNING COMPANY, INC.
gang
Nguyen ARMADILLO
WILLIES
urs-c SIZE
SC11E: SXEEi
I .
I -
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I
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I
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I
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i 4,_6i,
i
SAN JOSE
AWNING COMPANY, INC.
uxnvx rn
,xxxc xrurEx ARMADILL❑ WILLIES
offs E !!TE p_y
WPUE ED nxTE ax¢r SCALE
A1C-w W,C
WO60 6406 I dY OTHER
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7D WALL
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y�cT #8 X 1/2' An PLATED T(K SCREWS
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CITY OF CUPEATINO
I of 1 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY # 1
Sec: Twp: Rng: Sub: Elk: Lot:36901001.00' -
DATE ISSUED.... ... : 08/05/1999
RECEIPT #......... : 9750
REFERENCE ID # ...: 99080042
SITE ADDRESS .....: 10100 DE ANZA BLVD
SUBDIVISION .......
CITY ... . . ........: CUPERTINO
IMPACT AREA .......
OWNER ....... .. ...: ZANKICH MARTIN TRUSTEE _
ADDRESS ....... ... :
CITY/STATE/ZIP ... : SAN FRANCISCO CA, CA 94163
RECEIVED FROM .... : TIM
CONTRACTOR ....... : LIC #
COMPANY .......... :
ADDRESS ..........:
CITY/STATE/ZIP ....
TELEPHONE ........: '
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS REC NEW BAL
_______ _ _____--_-_
BPERMFEE VALUATION 5,000.00 107.00 0.00 107.00 0.00
EisMICOM VALUATION 4,200.00 1.05 ---------- ------1--- ______0_00
PERMIT 108.05 0.00 100.05 0.00
M D OF PAYMENT AMOUNT NUMBER
_________________ ____________ __________________
CHECK 108.05 17784
'
TOTAL-
OTAL RECEIPT 108 05
CITY OF CUPERTINO
1 of 1 BUILDING PERMIT RECEIPT OPERATOR: christya
COPY # 1
Sec: Twp: RnS: Sub: Elk: Lot:36901001.00
DATE ISSUED.. . . ... : 06/05/1999
RECEIPT #. . . . .....: 9750
REFERENCE ID # ...: 99080042
SITE ADDRESS ..... : 10100 DE ANZA BLVD
SUBDIVISION ...... .
CITY .............: CUPERTINO
IMPACT AREA ...... .
OWNER ............ : ZANKICH MARTIN TRUSTEE
ADDRESS .......... :
CITY/STATE/ZIP ...: SAN FRANCISCO CA, CA 94163
RECEIVED FROM ....: TIM
CONTRACTOR .......: LIC #
COMPANY ..........:
ADDRESS . .........:
CITY/STATE/ZIP ... .
TELEPHONE ........:
FEE ID UNIT QUANTITY AMOUNT PD-TO-DT THIS AEC NEW BAL
__________ _____________ __________ __________ __________ ----------
ID =�- DESCRIPTIONVOICE ID DESCRIPTION
•_ ___• •................ ........ ...... ...............
FOUNDATION 102 PIERS
103 UFER 104 REBAR
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUhIDING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH / 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE INVOICE
CITY OF CUPERTINO
BUILDING PERMIT INVOICE OPERATOR: christYa
4 t w
Sec: Twp: Rug: Sub: Blk: L6t:36901001.00
INVOICE DATE......: 08/05/1999
REFERENCE ID # ... : 99080042
SITE ADDRESS .....: 10100 DE ANZA BLVD
SUBDIVISION ...... .
CITY ... .......... : CUPERTINO
IMPACT AREA ...... .
OWNER ZANKICH MARTIN TRUSTEE
ADDRESS ..........:
CITY/STATE/ZIP ...: SAN FRANCISCO CA, CA 94163 -
e
CONTRACTOR .......: LIC #
COMPANY ..........:
ADDRESS ..........: .
CITY/STATE/ZIP .... ,
TELEPHONE ........:
FEE DESCRIPTION CHK TOTAL FEE PAID-TO-DATE BALANCE DUE
--------------- _-- --------- ____________ ______--_--
$PERMFEE P 107.00 0.00 107.00
BSEISMICOM P 1.05 0.00 1.05
_________ ____________ ___________
108.05 0.00 108.05
ID DESCRIPTION ... VOICE ID DESCRIPTION
.. ......................... ........ .............a..
FOUNDATION 102 PIERS
UFER 104 REHM
105 ANCHOR BOLTS 106 SEWER & WATER
202 UNDERFLOOR PLUMBING 203 UNDERFLOOR MECHANICAL
204 UNDERFLOOR FRAME 205 UNDERFLOOR INSULATION
301 ROUGH PLUMBING 302 TUB & OR SHOWER
303 ROUGH MECHANICAL 304 ROUGH ELECTRICAL
305 FRAME 306 HOLDOWNS
307 INSULATION 308 SHEETROCK
309 EXTERIOR LATH 310 INTERIOR LATH
311 SCRATCH COAT 313 ROOF NAIL
501 FINAL ELECTRICAL ENERGY 502 FINAL PLUMBING ENERGY
503 FINAL MECHANICAL ENERGY 504 FINAL BUILDING ENERGY
505 FINAL ELECTRICAL 506 GAS TEST
507 FINAL PLUMBING 508 FINAL MECHANICAL
509 FINAL GRADE 510 FINAL PLANNING
514 FINAL PUBLIC WORKS